Powdered formulas are not sterile. “To minimize the risk of infection, powdered formulas are not recommended for use in premature or immunocompromised infants unless no appropriate nutritional alternative is available, and then only with strict medical supervision and careful preparation, storage and use.”1
Preparation and Use Instructions1,2
Tube-feeding Hangtimes*† for Prepared Formula From: | Neonates or Immunocompromised Infants/Children | Infants and Children with Healthy Immune Systems |
---|---|---|
Ready-To-Feed unaltered infant formula (commercially sterile) | 4 hrs | 8 hrs |
Concentrated liquid formulas (commercially sterile) Powdered formulas (not sterile) | 4 hrs | 4 hrs |
Powder added to liquid formula or expressed breast milk3 | 4 hrs | 4 hrs |
Liquid (commercially sterile) added to expressed breast milk | 4 hrs | 4 hrs |
Failure to follow these instructions could result in severe harm.
*Adapted from: Robbins and Meyers, p.1002
†For reservoir and tube-change guidelines, refer to the ADA publication, Infant Feedings: Guidelines for Preparation of Formula and Breastmilk in Health Care Facilities. 2004.
1. International Formula Council. Infant Feeding: Safety Issues for Health Care Professionals. Atlanta, GA: International Formula Council; 2004:4. 2. Robbins ST, Meyers R, eds. Infant Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities. Chicago, Ill: American Dietetic Association; 2011. 3. Telang S, Berseth CL, Ferguson PW, et al. Fortifying fresh human milk with commercial powdered human milk fortifiers does not affect bacterial growth during 6 hours at room temperature. J Am Diet Assoc. 2005;105:1567-1572.
The American Dietetic Association is now known as the Academy of Nutrition and Dietetics